Definition & Overview

Penis is the external male sexual organ that is made up of skin, tissues, muscles, and blood vessels. It also contains the urethra, a tube that originates from the bladder and ends at the tip of the penis. The urethra not only carries urine, but semen as well, which is why the penis is a part of the urinary and reproductive systems.

The penis is made up of a shaft, which is the main part, and the head, also known as the glans. It also contains three chambers, two of which are called corpora cavernosa and are located in the upper portion. The other chamber, called the corpus spongiosum, which widens and forms the glans, is located right below them.

Like any other part of the body, the penis is also prone to growths. Some are benign (non-cancerous), but others are malignant (cancerous). These growths can appear anywhere on the penis, but benign growths are usually located on the glans or foreskin.

Benign growths are either condylomas (genital warts) or bowenoid papulosis. Both types are linked to Human papillomavirus (HPV) infection. Condylomas are small cauliflower-like growths while Bowenoid papulosis are small red or brown patches mostly located on the shaft. These growths are often mistaken for early stage cancer, but they usually do not present any problems. In fact, they’ll normally disappear after a few months without any medical intervention.

If the growths are cancerous, they can be categorized as squamous cell carcinoma, melanoma, basal cell carcinoma, adenocarcinoma, or sarcoma.

95% of penile cancers are squamous cell carcinoma, which has two main groups: verrucous carcinoma and carcinoma in situ (CIS).

Cause of Condition

Penile cancer is a rare occurrence in western countries but is more common in Asia, South America, and Africa. The exact cause of the condition is unknown. However, like any other form of cancer, this is characterized by the presence of abnormal cells that continue to grow.

Even though the exact cause or causes of penile cancer are unknown, experts on the condition have identified certain risk factors, such as HPV, poor personal hygiene, multiple sexual partners, cigarettes and other tobacco products, the presence of foreskin, and age.

  • HPV - HPV infection is usually caused by sexual contact with an infected person. Some forms of HPV do not cause cancer and will normally go away without any medical intervention. However, other forms, such as HPV 16 and HPV 18 are commonly found in men with penile cancer.

  • Age - Penile cancer mostly occur in men over the age of 60.

  • Smoking – smoking increases the person’s risk of developing penile cancer because of the chemicals in cigarettes, which include benzyrene, a known cancer agent.

  • Circumcision – penile cancer is more prevalent in uncircumcised men than in those who are circumcised. This is because secretions and dead skin cells often build up in the foreskin.

  • Treatment for Psoriasis – Treatment for psoriasis often includes the use of drugs called psoralen and phototherapy. Studies have shown that men who have undergone this type of treatment have an increased risk of developing penile cancer.

Key Symptoms

Penile cancer normally displays the following symptoms:

  • Penis rash
  • Difficulty drawing back the foreskin
  • Foul smelling discharge
  • Blood coming out of the tip or under the foreskin
  • Change in color
  • Growths on the penis that do not heal or disappear
  • Abdominal pain
  • Weight loss
  • Fatigue
  • Swollen lymph node in the groin
  • Painful bones

Who to See & Types of Treatment Available

If you experience any of the above symptoms, the first person to consult is your family doctor. If your doctor suspects penile cancer, you’ll be referred to a cancer specialist for further diagnosis and treatment.

To diagnose the condition, cancer specialists typically perform a blood test and biopsy. If these tests suggest the presence of penile cancer, additional tests will be performed and these can include an MRI, CT Scan, fine needle aspiration, sentinel lymph node biopsy, x-rays, bone scan, and a PET-CT scan.

If the tests confirm the presence of penile cancer, the specialist will run more tests to identify the stage of the cancer before developing an individualized treatment plan.

Treatment for penile cancer, which depends on the stage of the condition, typically includes medications, radiotherapy, chemotherapy, and surgery. Surgical procedures that are commonly performed to treat the condition are the following:

  • Glansectomy (removal of the penis head)
  • Circumcision (removal of the foreskin)
  • Penectomy (removal of the entire penis)
  • Lymphadenectomy (removal of the lymph nodes)
  • Laser surgery and cryotherapy
  • Mohs micrographic surgery
  • Wide local incision
    References:

  • National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Penile cancer. 2012. Version 1.2012.

  • Pettaway CA, Lance RS, Davis JW. Tumors of the penis. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 34.
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